169 research outputs found

    Customer equity drivers, customer experience quality, and customer profitability in banking services: the moderating role of social influence

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    Financial service organizations are increasingly interested in ways to improve the service experience quality for customers, while customers progressively perceive the commoditization of banking services. This is no easy task, as factors outside the control of the service firm can influence customers’ perceptions of their experience. This study builds on the customer equity framework to understand the linkages between what the firm does (customer equity drivers: value equity, brand equity, and relationship equity), the social environment (social influence), the customer experience quality, and its ultimate impact on profitability. Using perceptual and transactional data for a sample of customers of financial services, we demonstrate the central role played by factors under the control of the firm (value, brand, and relationship equity) and those outside its control (social influence) in shaping customers’ perceptions of the quality of their experience. We offer new insights into the moderating role of social influence in the linkages between the customer equity drivers and the customer experience quality. The managerial takeaway is that the impact of customer equity drivers on the customer experience quality is contingent on the influence exerted by other people and that enhancing customer experience quality can be a way to increase monetary returns

    Ureteritis Cystica: Important Consideration in the Differential Diagnosis of Acute Renal Colic

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    Ureteritis cystica is an uncommon cause of acute renal pain. The aetiology remains unclear and the diagnosis may be difficult to establish. We report the case of a 29 year old woman with a history of repeated urinary tract infections presenting with acute renal colic in the absence of lithiasis. We review the diagnostic tools available to make the diagnosis and the recent pertinent literature

    Pulmón del soldador asociado a sobrecarga sistémica de hierro: a propósito de una caso

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    La hemosiderosis pulmonar o pulmón del soldador es una enfermedad ocupacional, provocada por la exposición crónica al polvo de hierro, en la que se produce un depósito anormal de este material en el pulmón en forma de hemosiderina

    Protective role of vitamin B6 (PLP) against DNA damage in Drosophila models of type 2 diabetes

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    Growing evidence shows that improper intake of vitamin B6 increases cancer risk and several studies indicate that diabetic patients have a higher risk of developing tumors. We previously demonstrated that in Drosophila the deficiency of Pyridoxal 5' phosphate (PLP), the active form of vitamin B6, causes chromosome aberrations (CABs), one of cancer prerequisites, and increases hemolymph glucose content. Starting from these data we asked if it was possible to provide a link between the aforementioned studies. Thus, we tested the effect of low PLP levels on DNA integrity in diabetic cells. To this aim we generated two Drosophila models of type 2 diabetes, the first by impairing insulin signaling and the second by rearing flies in high sugar diet. We showed that glucose treatment induced CABs in diabetic individuals but not in controls. More interestingly, PLP deficiency caused high frequencies of CABs in both diabetic models demonstrating that hyperglycemia, combined to reduced PLP level, impairs DNA integrity. PLP-depleted diabetic cells accumulated Advanced Glycation End products (AGEs) that largely contribute to CABs as α-lipoic acid, an AGE inhibitor, rescued not only AGEs but also CABs. These data, extrapolated to humans, indicate that low PLP levels, impacting on DNA integrity, may be considered one of the possible links between diabetes and cancer

    Efficacy and Tolerability of 6-Month Treatment with Tamsulosin Plus the Hexanic Extract of Serenoa repens versus Tamsulosin Plus 5-Alpha-Reductase Inhibitors for Moderate-to-Severe LUTS-BPH Patients: Results of a Paired Matched Clinical Study

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    The objective of this subset analysis was to evaluate and compare the efficacy and tolerability of two combination treatments for men with moderate-to-severe lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). Data were from a real-world, open-label, prospective, and multicenter study performed in outpatient urology clinics. Men with moderate-to-severe LUTS/BPH received 6-month treatment with tamsulosin (TAM) in combination with either the hexanic extract of S. repens (HESr) or a 5-alpha-reductase inhibitor (5ARI). Changes in urinary symptoms and quality of life were measured using the IPSS and BII questionnaires, respectively. Treatment tolerability was assessed by recording adverse effects (AEs). Patients in the two study groups were matched using iterative and propensity score matching approaches. After iterative matching, data were available from 136 patients (n = 68 treated with TAM + 5ARI, n = 68 with TAM + HESr). After 6 months of treatment, mean (SD) IPSS total score improved by 7.7 (6.3) and 6.7 (5.0) points in the TAM + 5ARI and TAM + HESr groups, respectively (p = 0.272); mean BII total scores improved by 3.1 (2.9) and 2.9 (2.4) points (p = 0.751), respectively. AEs were reported by 26.5% and 10.3% of patients in the same groups, mostly affecting sexual function (p < 0.027). When used in a real-world setting to treat patients with moderate-severe LUTS/BPH, 6-month treatment with TAM + HESr was as effective as TAM + 5ARI, but with better tolerability. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

    Contamination of public parks and squares from Guarulhos (São Paulo State, Brazil ) by Toxocara spp. and Ancylostoma spp.

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    The contaminated soil with mammal feces is an important factor of risk to infection with zoonotic diseases. Amongst these zoonoses are visceral larva migrans and cutaneous larva migrans caused by Toxocara spp. and Ancylostoma spp., respectively. The aim of this study was to assess the environmental contamination by Toxocara spp. eggs and hookworms (Ancylostoma spp.) in public parks and squares in the city of Guarulhos, a metropolitan area of São Paulo, São Paulo State, Brazil. Soil samples were collected, between September and December 2010, and examined using the centrifugal flotation technique with sodium dichromate and zinc sulphate as well as the modified Baermann method. Notably, 35 (74.5%) of the 47 districts surveyed in Guarulhos possessed samples contaminated with Toxocara spp. and/or eggs or larvae of Ancylostoma spp. The frequency of Toxocara spp. and Ancylostoma spp. in the samples from public areas was 68.1% and 46.8%, respectively. Overall, the eastern side of Guarulhos is the region with the highest occurrence of causative agents of larva migrans. In all collection sites, the presence of feces from dogs and cats accompanied by their owners and stray animals were observed. Notably, it is important to adopt measures to control dog and cat breeding, to treat infected animals, and provide health education to the population

    Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support

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    <p>Abstract</p> <p>Background</p> <p>Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved.</p> <p>Method</p> <p>This paper introduces a new hybrid methodology <it>Expert-based Cooperative Analysis </it>(EbCA), which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK) to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1) Bench-marking of small mental health areas based on technical efficiency estimated by <it>EbCA-Data Envelopment Analysis (EbCA-DEA)</it>, and 2) Case-mix of schizophrenia based on functional dependency using <it>Clustering Based on Rules (ClBR)</it>. In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases.</p> <p>Results</p> <p>EbCA is a new methodology composed by 6 steps:. 1) Data collection and data preparation; 2) acquisition of "Prior Expert Knowledge" (PEK) and design of the "Prior Knowledge Base" (PKB); 3) PKB-guided analysis; 4) support-interpretation tools to evaluate results and detect inconsistencies (here <it>Implicit Knowledg </it>-IK- might be elicited); 5) incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6) post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering), applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases.</p> <p>Discussion</p> <p>This paper presents EbCA and shows the convenience of completing classical data analysis with PEK as a mean to extract relevant knowledge in complex health domains. One of the major benefits of EbCA is iterative elicitation of IK.. Both explicit and tacit or implicit expert knowledge are critical to guide the scientific analysis of very complex decisional problems as those found in health system research.</p

    TINC — A Method to Dissect Regulatory Complexes at Single-Locus Resolution — Reveals an Extensive Protein Complex at the Nanog Promoter

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    Cellular identity is ultimately dictated by the interaction of transcription factors with regulatory elements (REs) to control gene expression. Advances in epigenome profiling techniques have significantly increased our understanding of cell-specific utilization of REs. However, it remains difficult to dissect the majority of factors that interact with these REs due to the lack of appropriate techniques. Therefore, we developed TINC: TALE-mediated isolation of nuclear chromatin. Using this new method, we interrogated the protein complex formed at the Nanog promoter in embryonic stem cells (ESCs) and identified many known and previously unknown interactors, including RCOR2. Further interrogation of the role of RCOR2 in ESCs revealed its involvement in the repression of lineage genes and the fine-tuning of pluripotency genes. Consequently, using the Nanog promoter as a paradigm, we demonstrated the power of TINC to provide insight into the molecular makeup of specific transcriptional complexes at individual REs as well as into cellular identity control in general.Anja S. Knaupp, Monika Mohenska, Michael R. Larcombe, Ethan Ford, Sue Mei Lim, Kayla Wong, Joseph Chen, Jaber Firas, Cheng Huang, Xiaodong Liu, Trung Nguyen, Yu B.Y. Sun, Melissa L. Holmes, Pratibha Tripathi, Jahnvi Pflueger, Fernando J. Rossello, Jan Schro, der, Kathryn C. Davidson, Christian M. Nefzger, Partha P. Das, Jody J. Haigh, Ryan Lister, Ralf B. Schittenhelm, and Jose M. Pol
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